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What bishops want.

Today, Cardinal Timothy Dolan released a statement outlining the USCCB's objections to the Obama administration's revision of the revision of the contraception mandate. The new rule scotches the previous iteration's much-maligned four-part definition of "religious employer," and proposes arrangements to make sure religious employers -- including colleges, hospitals, and charities -- won't have to pay for or refer for contraception coverage in their employee health plans. In other words, the Department of Health and Human Services listened to its critics and attempted to allay their concerns.

As the editors ofCommonweal put it, "This will do."The U.S. Conference of Catholic Bishops disagrees.

First, a word of praise for the tone of Cardinal Dolan's statement. It avoids the hyperbolic rhetoric that has characterized this debate for far too long. The cardinal states that the bishops are open to further discussion. He acknowledges that the Obama administration "has heard some previously expressed concerns and that it is open to dialogue," and promises "additional, careful study." He notes that the new proposal does away with the "exceedingly narrow" definition of "religious employer," which, the bishops claimed, "created a 'second class' of citizenship within our religious community" -- subordinating Catholic charities to Catholic parishes. But apparently that's not enough for the bishops.

"The administration's proposal maintains its inaccurate distinction among religious ministries. It appears to offer second-class status to our first-class institutions in Catholic health care, Catholic education, and Catholic Charities." Yet Dolan fails to mention what replaced the four-part definition. The USCCB had called that definition "unprecedented" in federal law. So HHS lifted the revised definition from something with plenty of precedent: the federal tax code. According to the new rule, any religiously affiliated employer that has nonprofit status simply has to self-certify with HHS in order to opt out of the contraception mandate. If the employer pays an insurance company for employee health coverage, it has to notify the insurer that it doesn't want contraception included in the plan, and the insurer in turn automatically enrolls employees in a separate plan at no cost to them or to their employer. If the objecting employer is self-insured, it just has to inform its plan administrator, which will arrange for free contraception coverage for employees.

(This is where it gets complicated. "Self-insurance" is a misnomer. Rather than pay an insurance company premiums, some employers prefer to pay directly for their employees' health care. This requires a lot of cash. Such companies typically pay an insurance company to handle administrative tasks. The administrator generates "insurance cards" for the employees, and every time a worker incurs a medical expense, the administrator handles the paperwork and bills the employer for the service, according to an agreed-upon fee schedule. Administration fees are much lower than insurance premiums, so requiring administrators to cover the upfront costs of contraception would be unfair. They'd be paying for savings that accrue only to the "self-insured" company -- covering people who don't want babies is cheaper than covering those who do. That's the financial incentive for insurers to give away contraception to people they already cover. In order to make it worthwhile for administrators of "self-insured" plans, HHS proposes to reduce fees insurance companies will have to pay in order to sell their plans on the new health-care exchanges. Either way, the idea is that no religiously affiliated employer will have to contract for, pay for, or refer for contraception coverage.)

So why does Cardinal Dolan say, "there remains the possibility that ministries may yet be forced to fund and facilitate such morally illicit activities"? No arrangement proposed by HHS would oblige a Catholic institution to fund contraception coverage. But what about "facilitate"? This is the next line of defense. A bishop might argue: Sure, HHS may say that religiously affiliated employers won't have topay for contraception, but there's no getting around the fact that our employees wouldn't receive that coverage if they didn't have the insurance policy we provide. But the Affordable Care Act mandates that everyone have a health-insurance plan -- regardless of employment status. So even if a scrupulous Catholic employer canceled its employee health-care benefit (likely replacing it with cash payments), its workers would still need to buy health insurance -- insurance that would certainly include contraception coverage. The facilitation argument doesn't withstand scrutiny. What's to keep employees from using their salaries to engage in morally illicit acts? Think of all the illicit acts made possible by gainful employment. This is the slipperiest of slopes.

The Catholic tradition developed categories of "cooperation with evil" to help us think through this kind of problem. Without intending the employee to use contraception, without securing or paying for contraception coverage for its employees, a Catholic institution is not involved in a morally illicit act. If an employee wants to use free contraception provided by a third party, that's on her. There's no way to wall off an employee's moral agency. Yet Cardinal Dolan protests that the new proposed rule "would require all employees in our 'accommodated' ministries to have the illicit coverage -- they may not opt out, nor even opt out for their children -- under a separate policy." Cardinal Dolan seems to say that contraception coverage is itself illicit, but the Catholic moral tradition doesn't hold that things in themselves are licit or illicit. Acts are. So Catholic teaching would say that forcing a bishop to provide contraception coverage may be morally illicit. Just as it would say that using contraception is illicit. But the coverage itself has no moral character. It's like saying a drug store shouldn't be selling contraception in a Catholic neighborhood. The availability isn't the problem. An employee may or may not use the free contraception coverage. Until she does, nothing illicit has happened. And if she does, it's not the employer's fault.Cardinal Dolan also expresses his displeasure with the fact that the revised rule does not address the complaints of for-profit employers who have religious objections to the mandate. They "have no conscience protections at all," Dolan writes. Matt Boudway covered this question earlier this week. Should any employer be able to opt out of federally established basic health-insurance benefits because of religious objections? Matt writes:"It would logically lead to a situation they couldn't possibly wish for. Should an overzealous Jehovahs Witness be able to get a group plan that excludes coverage for emergency blood transfusions, even if none of his employees are coreligionists?" The bishops tend to treat conscience claims as though they outweigh everything. In fact, conscience claims must be balanced against state interests (whether the contraception mandate advances a legitimate state interest is another question).

"Throughout the past year," Cardinal Dolan writes in the concluding paragraph, "we have been assured by the administration that we will not have to refer, pay for, or negotiate for the mandated coverage. We remain eager for the Administration to fulfill that pledge." As the bishops continue to study HHS's new proposals, I hope they come to realize that the Obama administration has done just that.

Follow up: Matthew Franck has responded to this post with something shy of full understanding of health insurance. Here's my reply.

Comments

What the bishops want is pretty simple -- to impose their archaic view of catholic morality as the law of the land. Make artificial contraception illegal -- after all, it is "intrinsically evil," or so they say. Make homosexual acts illegal -- same rationale. The catholic church -- the people of God -- soundly reject the bishops and their 17th century views. The rest of the country should do the same.

Grant:"so requiring administrators to cover the upfront costs of contraception would be unfair." So the heck what? THAT is none of Dolan's business.Moreover, non-profits and especially religious non-profits and ESPECIALLY Catholic non-profits shouldn't be allowed to self-insure anyway.If you'd like to know why, ask the creditors who got screwed in the San Diego, Portland, OR and Milwaukee (Cardinal Dolan's old see) diocesean bankruptcies because of inadequate or non-existent liability insurance.Clearly, this isn't about "religious liberty" anymore (not that it ever was). It's about the Catholic Church trying to retain their perverted patriarchical control over women's sexuality.BTW, a warning for Dolan and the rest of the USCCB: This is like the FIFTH time Obama has employed this same negotiating strategy and when he whips Dolan it'll be the fifth straight win. Obama gives ground, the left shrieks, the liberals coo, the conservatives reject it and the right-wing smells blood because they think Obama is an easy mark. Obama gives more ground, more shrieking, cooing, rejecting and blood-smelling. He gives even more ground and just when it looks like Obama is about to defeat himself, the right-wingers are flat on the ground smelling their own blood, the conservatives have nothing to reject, the liberals are dumbfounded and the left slinks off to find something else to shriek about.Dolan would have been well-advised to take this deal. Since he didn't, he should brace himself to be destroyed.

"Dolan would have been well-advised to take this deal. Since he didnt, he should brace himself to be destroyed."I don't think he's rejected the deal. i agree with Grant's comment about he tone of the statement.The article on th USCCB website summarizes his issues as follows:

Cardinal Dolan highlighted problems with the proposed "accommodation.""It appears that the government would require all employees in our 'accommodated' ministries to have the illicit coveragethey may not opt out, nor even opt out for their childrenunder a separate policy," he said.He also noted that "because of gaps in the proposed regulations, it is still unclear how directly these separate policies would be funded by objecting ministries, and what precise role those ministries would have in arranging for these separate policies. Thus, there remains the possibility that ministries may yet be forced to fund and facilitate such morally illicit activities."Cardinal Dolan also said the proposal refuses to acknowledge conscience rights of business owners who operate their businesses according to their faith and moral values.

My guess is that the first issue is mostly about Catholic parents being able to block their children (who may be covered until they are 26 years old) from getting free contraceptives. Otherwise, the employee could just not use contraceptives her/himself even if she/he automatically received a policy. They may have a chance of getting this change. This is a new issue that they haven't brought up before. The second issue doesn't object to anything that has been proposed - just says we need to see all the details before we endorse this - to be sure we're not paying or facilitating the coverage. The third point is the Taco Bell/Hobby Lobby proposition. I suppose they felt they had to express solidarity with them but I think there is about zero chance that they will get this. It will be resolved by the Supreme Court , someday.

I may be completely at sea here, but is it possible that the bishops see their fighting the HHS mandate, raising issues about religious freedom, etc. as a way to encourage and show solidarity with those Catholics who use Church-approved NFP techniques? What seems to be happening, though, is that position of the bishops seems to irritate the larger number of Catholics who use contraception counter to Church teaching and apparently hold it as morally neutral for husbands and wives as those in Protestant denominations. NFP may be perfectly effective, but the fact that it is promoted by a Church that bans every form of artificial contraception is enough to make many folks hinky about it.Am I wrong to wonder whether the bishops are just trying to ensure that they aren't cooperating in sin? Or whether they're also sending a message to those Catholics who aren't in line with contraceptive teaching? And, if the latter, is this an effective mode of faith formation? Or does it merely separate those in the small, pure Church from those who try to be Catholic have a harder time reconciling Church teaching to modern practicalities?

John Hayes:"I dont think hes rejected the deal."With all due respect, hogwash: "At the same time, we will continue to stand united with brother bishops, religious institutions, and individual citizens who seek redress in the courts for as long as this is necessary." That means he's continuing his opposition unabated.In fact, Dolan has INCREASED his demands, since he's now thrown in with the secular for-profit employers also trying to impose their personal patriarchial control of women's sexuality. Just like those blood-smelling right-wingers I mentioned above, Dolan is under the mistaken impression that Obama is being rolled. He's not. The Church is about to get rolled--and they won't see it coming anymore than the Republicans saw Heath-Care passage coming, or Hillary or Romney saw defeat coming, or Boehner saw the sequester coming.I hope you're right, but I believe you're wrong. This is a fight the Bishops CANNOT win, and the sooner they realize that, the better for everybody.

Jean Raber:"raising issues about religious freedom, etc. as a way to encourage and show solidarity with those Catholics who use Church-approved NFP techniques"That is an interesting observation, one that I would never have thought of and I have not seen it expressed enywhere else. Cynic that I am, I would say that such a motivation is far down on the totem pole. A more likely motivation might be to save face for all the money put into Ad Hoc Committee on Religious Liberty, Fortnight for Freedom, law suits and lawyers.

The new rule scotches the previous iterations much-maligned four-part definition of religious employer, and proposes arrangements to make sure religious employers including colleges, hospitals, and charities wont have to pay for or refer for contraception coverage in their employee health plans. The proposed new rule limits the exemption to "churches." If colleges, hospitals, and charities can be squeezed into that definition, if they can be characterized as "churches" themselves, then they will be exempt. Problem is that many of these agencies cannot be characterized as "churches," especially when the Notice itself expressly states that it does NOT contemplate that the proposed new rule will expand the number of entities that will be able to claim the exemption.

This is a Becket Fund talking point. The bishops asked that religiously affiliated employers not be forced to contract for, pay for, or refer for contraceptive coverage. The new proposal does that. If the bishops want to argue that no employee of a Catholic hospital should be able to get contraception coverage arranged by the government and paid for by a third party, even though many of those people aren't Catholic, they'll have a tough time winning.

I must be very cynical because I think what the bishops want is to display their power. I read a news article in which some bishops said they would be willing to go to jail rather than comply with the HHS mandate. An empty assertion - they know Obama would never do that - he instead tries again and again to compromise. If only just one of the bishops had the integrity to be willing to go to prison for speaking the truth about the sex abuse cover-ups. But no.

I don't know if it's power the bishops want to display so much as rectitude and firmness. Their moral authority is at at a low point now and still ebbing with every page of documents released in Los Angeles, and who knows where else. They need to show resoluteness about something larger than their own perks and privileges. If they can be seen by some people as scourges of evil and stout defenders of freedom, although as unreasonable and ridiculous by others, it's a victory for them, whether or not they ultimately lose the legal and regulatory cases. Or especially if they lose, if it gives them another chance to rail against overreaching government and the onset of tyranny. What is more satisfying than a bloodless martyrdom?So I don't expect the bishops will ever say, "All right, Mr. President! You've answered all of our concerns."

The Bishops' selectivity in their defense of individual conscience rights undermines any effort to pose as "stout defenders of freedom." Their wall of silence on abuses of power within their own ranks speaks for itself. History is not likely to be kind to them.

I noted, as well, the more measured tone of Cardinal Dolan's current statement. That's a good thing. But I couldn't help wondering if last year's heated rhetoric wasn't politically motivated--at least in part. "If we can get people angry enough, we just may get him voted out of office." Well, that's no longer an option, so there's no need to sound so angry.

It seems to me that the position of the bishops has shifted from not wanting Catholic organizations (and private businesses) to be responsible in any way for providing their employees with insurance coverage for contraception to wanting Catholic organizations (and private businesses) to be able to prevent their employees from getting insurance coverage for contraception.

"In fact, conscience claims must be balanced against state interests"I don't quite know what "balanced" means here. The way I'd express it, if I could have my druthers regarding religious liberty and conscience protections, is that conscience claims should always prevail over state interests (that seems to be the point of religious liberty protections), unless the state interest is deemed to be sufficiently compelling. Not all state interests are particularly compelling. Free contraception for women of voting age would be one example of a not-very-compelling state interest.

It may be that Cardinal Dolan sees the long game oh how this country is going. It seems by a stroke of the pen, HHS can change wording of a document to make or unmake religious institutions doctrine. By adding more regulations, making the government controller in chief, the ability of this country to compete in the world is slowly dwindling.While all these social "regulations", & entitlements, like SS, Medicare & Affordable Medical Care, may sound great, the country going deeper in debt to other countries. Kind of like the old pusher, "the 1st ones free" mentality. Unfortunately there is no free lunch, & someday History may not be kind to these generations.

"Yet Cardinal Dolan protests that the new proposed rule would require all employees in our accommodated ministries to have the illicit coverage they may not opt out, nor even opt out for their children under a separate policy."This claim confuses me. Is the intent of the proposed rule that all employees will be issued a policy for free contraceptives, and the employee has no right to refuse the policy? I suppose there are all sorts of things that can get issued to a person but never used - people can get driver's licenses but never drive - but I wouldn't want to be bound by an insurance policy - a contract - without my consent.John Hayes' point is astute about the hypothetical employee with a conscientious objection to contraceptives who is also a parent with daughters in their teens or early-mid 20's. It's a fine reason to scrap this whole HHS contraption and replace it with a direct government entitlement. I can't imagine many 25 year old women want mom or dad's permission to have a sex life.

"I dont know if its power the bishops want to display so much as rectitude and firmness."Yes, I guess that's how I see it, too. I'm either not cynical enough about or engaged enough in the Church to see carping about HHS contraceptive mandates as a diversionary tactic from sex abuse cover-ups or church-state wrangles."I wish the bishops would so robustly defend individual conscience protections for taxpayers with moral objections to the wars were currently financing."Yes, agree here, too. The bishops, in their rejection of various accommodations perhaps feel that this is a way to let the faithful know they're dead serious about the "pelvic rules" in the CCC--and they risk making themselves look overly preoccupied with them. Certainly, there was a distinct difference between our old, Vat2 bishop and his current JPII successor. Voter's guides used to cover a wide range of issues with helpful explanations of Catholic doctrine. In this past election, the only non-sexual issue covered was immigration. Explanations were less helpful.

I am most probably going to have to deal with this issue with some parishioners and possibly the RCIA group this Sunday. Grant (and maybe David Gibson), here is a question that if you had an answer I think it would be most helpful to me:Who do you really think is advising Dolan on this which seemingly is leading him to take such an intransigent position? Do you surmise it is the likes of Robby George, George Weigel etc? Is there any evidence that the some bishops may be more amenable to a compromise?

Its a fine reason to scrap this whole HHS contraption and replace it with a direct government entitlement. I cant imagine many 25 year old women want mom or dads permission to have a sex life.Jim,If a 25-year-old woman is covered by her parents' insurance, they are paying for it, and if they say she can't use the coverage to pay for contraception, she has to live with that. The parents, as the owners of the policy, will be the ones dealing with the insurance company. They don't need a way to "opt out" of the coverage for their daughter. They just have to tell her not to attempt to use the coverage for contraception. I don't understand the idea that it is so horrible to make people complicit in providing contraceptive coverage for others, that the government just ought to provide it for everybody! Contraception is so damaging and so sinful, and causes cancer, and causes men to lose respect for women, etc., etc., so the solution is for the government to provide it to all women for free!

The bishops of the USCCB are acting like a bunch of Lord Granthams from Downton Abbey. Robert Crawley, the seventh earl of Grantham, the messed up pretty badly. He lost his wifes inheritance with a bad investment and had a significant part in the death of his daughter. Shouldnt he feel a bit of guilt? Not at all. He is seen in last weeks episode ranting about bringing his grandchild up as a Catholic and berating his wife and daughters for being served lunch by a reformed prostitute - all the while living a rather luxurious life.A bit of displacement?Meanwhile his wife and daughters are daring to contradict him.Milord, (which by the way is how the British address bishops) Grantham, methinks you are losing power, authority and credibility.

"I will eat my hat if they eat crow (agree to the compromise)."I'm not sure if it's really for the bishops to agree. The mandate is a fait accompli. I'd think that, according the standard political calculus of the sort used all the time by the White House and Congress, the bishops are basically an interest group, lobbying for more favorable treatment.

"If a 25-year-old woman is covered by her parents insurance, they are paying for it, and if they say she cant use the coverage to pay for contraception, she has to live with that. The parents, as the owners of the policy, will be the ones dealing with the insurance company. They dont need a way to opt out of the coverage for their daughter. They just have to tell her not to attempt to use the coverage for contraception."I'm confusing myself even more here.The question on the table seems to be: would a parent/policy holder of the contraceptive coverage, whether the benefit is part of the employer's group policy or via a special exemption policy issued directly by the insurance company, have the ability to prevent his grown daughter from receiving the benefit?

"I dont understand the idea that it is so horrible to make people complicit in providing contraceptive coverage for others, that the government just ought to provide it for everybody! "Well, my own preference is "none of the above" - consumers can just pay for their own contraceptives, and deal with the consequences, without needing to involve her parents, the parents' employer, the parents' employers' insurance carrier, or the government in the decision But that ship probably has sailed.

Everyone knows what the bishops want. As Abe Rosenthal puts it on his blog today:"From the start, the Church has used the mandate controversy to try to get the government to do what it has failed to do through preaching and dictates from the Pope prevent Catholic women from accessing birth control to manage their reproductive lives so they can bear children when they choose and, equally important, participate in the work force."http://takingnote.blogs.nytimes.com/2013/02/08/the-church-and-the-mandat...

(2) A group health insurance issuer that receives a copy of the self-certification described in paragraph (a)(4) of this section with respect to a plan for which the issuer would otherwise provide coverage for any contraceptive services required to be covered under 54.9815- 2713(a)(1)(iv) must automatically provide health insurance coverage for any contraceptive services required to be covered by 54.9815-2713(a)(1)(iv) and identified in the self- certification, through a separate health insurance policy that is excepted under 45 CFR 148.220(b)(7), for each plan participant and beneficiary....An issuer providing contraceptive coverage arranged pursuant to paragraph (b) or (c) of this section must provide to plan participants and beneficiaries written notice of the availability of the contraceptive coverage...."You and any covered dependents will be enrolled in this separate individual health insurance policy at no additional cost to you".

There seems to be an inconsistency between the last sentence, which implies that everyone in the family is included in one policy and the earlier sentences which suggest the each person gets an individual policy and notice (employed mother with three daughters = 4 policies and 4 notices. It seems that what Cardinal Dolan wants is that the notice would allow the employed woman to accept or reject he coverage for herself and for her daughters. I suppose that would lead to a discussion of whether it's "opt-in" or "opt-out" and whether it's all daughters or whether adult daughters could make their own decision to accept or reject.My guess is that the number of people who would reject would be rather small, but the bishops might put on a campaign to urge people to reject.

It is worthwhile to recall that even prior to the Supreme Courts decision in Griswold v. Connecticut, the Catholic Church did not oppose the Massachusetts Legislatures lifting of the ban on the sale of contraceptives. In a submission to the Legislature in 1965, Richard Cardinal Cushing stated that I as a Catholic have absolutely no right in my thinking to foist through legislation or through other means, my doctrine of my church upon others. It is important to note that Catholics do not need the support of the civil law to be faithful to their religious convictions. I devoutly wish that the current USCCB would embrace the spirit of Cardinal Cushings 1965 remarks. Employers compensate employees for their labor. That compensation is paid in the form of salary and benefits. Our civil law permits the sale and purchase of contraceptives. The choice as to whether to purchase contraceptives is left to the individuals conscience. The employer no more facilitates the purchase of contraceptives by providing an insurance benefit to an employee than it does by providing a salary to an employee. The current federal proposal goes even further in removing an employer from the employees decision to purchase or not purchase contraceptives. The USCCB should accept it.

The answer to the inconsistency may be that the "separate health insurance policy" may be just one policy (covering only contraception) that covers all employees of that firm rather than a separate policy for each employee and beneficiary. People would then be enrolled in that plan, just as they are in the employers regular plan

Find this whole reply to be interesting because it reflects much of the debate in the 4th session of VII over Dignitatis Humanae.From John O'Malley,SJ's book and paraphrasing:"John Courtney Murray,SJ as the council was closing put his finger on a *the issue under the issue* - development of doctrine. In his words, it was the problem of elaborations of church teachings that went beyond, or even contradict, previous teachings. i.e. the problem of change.Murray went on to elucidate the repeated condemnations of *the separation of church and state*; *conscience*; *religious liberty*; etc. as pronounced by popes since the 18th century. And this topic was a bitter struggle and yet, Murray's ideas prevailed.He noted that in this council struggle on *religous liberty* the US bishops came in full force. Yet, this support echoed the American experience - US church did not live in the 19th century European mindset which can be summarized as - if the majority of a state's citizens are Catholic, then the state must profess being Catholic and was duty bound to suppress other religions; even denying their civil rights. If Catholics are a minority, then the state mus tolerate and guarantee free practice of religion.His views prevailed and can be summarized as - religious liberty and the rights of religious bodies in society; as well as the legitimate limits to expression of religious liberty, must be made evident and as appropriate for the good of society.It is interesting to note the change via the current USCCB on this issue. In tone and approach, the USCCB appears to reach back to the 19th century mindset; to echo the fierce objections about Murray's ideas from Rev. Joseph Fenton. Why? Because Dignitatis Humanae lays down two basic foundational principles - the every individual has the right to use conscience to choose and that no government has the right to obstruct this so long as it does not infringe on the right of others or hinder the common good; second, that this human dignity can not be coerced.Realize that terms such as common good and access to contraception can be argued but my point is that the USCCB appears to be operating with a new foundational principle - US government must allow the Catholic Church its preferences and anything less will be a loss of religious liberty. Appears to ignore the foundational principles of Dignitatis Humanae - fact that in a civil society there are diverse and multiple religious bodies or secular views that must be respected and protected. Sorry, USCCB seems to be recycling Fr. Fenton.

"It seems that what Cardinal Dolan wants is that the notice would allow the employed woman to accept or reject he coverage for herself and for her daughters."It's complex.Wearing my dad hat: I view my parental prerogatives in this regard differently with respect to my 15-year-old teenager than I do to my 25-year-old daughter. (I don't really have any children those ages, I'm just speaking hypothetically here). I'd have no problem whatsoever in laying down and enforcing the family law for the 15 year old (the pertinent family law being, No sexual activity, period), and I wouldn't want my employer or its insurance company - or the government - circumventing my parental authority by essentially giving away contraceptives to my 15 year old against my wishes. I think the case for the 25 year old is harder. Frankly, unless she is in medical school or some such, I don't want my 25 year old to be dependent on me for anything. She's an adult, and I want her to be responsible for her life by then. If she comes to me for advice - well, that's no problem, folks around here know I have no trouble telling others how to live their lives. But if she is dependent on me for health care under ACA rules, and she wishes to take advantage of the free-contraceptives benefit, does that make me complicit to her presumably-sinful behavior in some way? There are two possibilities for complicity: (1) she would need my express permission as policyholder to take advantage of the free-contraceptives benefit. If I give her permission, that seems pretty cut-and-dried complicity on my part. Or, (2) she is able to take advantage of the free-contraceptives benefit without needing my permission; essentially, she can fill her prescription, unbeknownst to me, and even against my wishes, because I've arranged for her to have an insurance card (which she would need, not just for contraceptives, but for all sorts of virtuous health care needs). In that scenario, I don't think I'm complicit.

It seems to me that having an opt out option for contraceptive coverage creates a very real danger that a Catholic-associated employer could call a meeting of their staff, pass out the forms to opt out, and tell the staff "you are expected to sign this and turn it in to your supervisor- we will mail them to the insurer". Even if this was in a grey area legally it would be very hard for the employees to prove this wasn't voluntary, and they might reasonably fear their jobs were at risk if they refused to sign. Also, shouldn't the bishops consider that someone who opted out of contraceptive coverage would be taking a huge risk if she (or an adult daughter) developed one of several serious medical conditions which are treated using the pill? I'd be particularly concerned about minimum wage employees where the cost of getting the pill with their own money might be prohibitive.

Jim Pauwels, i think it's your (2) but the insurance she automatically got from the third-party (not your employer) as your dependent only covers contraceptives. I think that's what the bishops would like you to be able to opt her out of. The issue of whether a young girl could get a doctor to write a prescription for contraceptives without your knowledge may depend on your state laws. I'm not sure I remember the age correctly, butI think that once she becomes 18, she has a legal right of health privacy and her doctors can't discuss their dealings with her with you without her permission.

Jim Mvrea:Perhaps I was too hasty. It appears Dolan does know that Obama is not the rollee but the roller.In the best sense of the term, the Cardinal is most politic.I was going to try to use the term "Politese" but the association with the Rolling Stones would have been most impolitic of me.

Jim P: as a former benefits manager I know of no circumstances in which an employee duly enrolled her/his dependants under health plan coverage and retained the rights to determine which, if any, of the plan's provisions said dependants could use.I don't think that there would be a practical way for any plan administrator to verify that each and every use of the plan by a dependant has the prior or expressed permission of the employee.

"The issue of whether a young girl could get a doctor to write a prescription for contraceptives without your knowledge may depend on your state laws. Im not sure I remember the age correctly, butI think that once she becomes 18, she has a legal right of health privacy and her doctors cant discuss their dealings with her with you without her permission."I'm sure you're right about 18 year olds.Regarding younger teens: I just did a very little roaming around on Google, and it seems that the general rule of thumb is that teens who are mobile without their parents and are sufficiently motivated can get both non-prescription and prescription-only birth control without their parents' consent. This site, which for all I know may know what it's talking about, says the following:"In the United States, some contraceptives are easily available such as male and female condoms and sperimicides, and minors may legally purchase them without a prescription. Other contraceptives require a prescription or are supplied (i.e. Depo-provera injection) by a health care provider. In most states, contraceptive counseling and distribution is confidentially available to minors (i.e. there is no parental notification requirement). Some states do have restrictions which may or may not be enforced."http://www.pediatriceducation.org/2011/01/24/what-are-the-laws-regarding...

"as a former benefits manager I know of no circumstances in which an employee duly enrolled her/his dependants under health plan coverage and retained the rights to determine which, if any, of the plans provisions said dependants could use."Right, Jim McC - you're saying that, once the dependent is enrolled in the benefit, the whole benefit is available to the dependent. But, if I take Dolan's meaning correctly (and I may not be), his scenario is slightly different. His scenario would work like this:* Parent works for an employer, like a Catholic hospital, for which the Obama Administration is now carving out this special exemption.* Parent enrolls dependent children (up to age 26) in employer's group health plan, which does not include contraceptives.* Pursuant to new HHS mandate exemption rules, parent's employer's insurance company proactively issues a special policy that covers only contraceptives, to the policy holder and his dependents.Cardinal Dolan's question is, can the parent refuse this coverage, on his own behalf, and on behalf of his dependents?

The simplest solution to the issues raised by the U.S. Catholics bishops regarding the HHS regulations would be for all Catholic institutions to stop paying for health-care insurance for their employees and instead pay their employees a cash payment equivalent to the employer's share in the insurance coverage.It would then be up to the employees to secure their own health insurance and pay the premiums.

In case you didn't follow the link in Jim McCrea's post of 3:25 pm, here's what +Dolan wrote:"Yesterday, I issued a statement in my role as President of the United States Conference of Catholic Bishops on the Notice of Proposed Rulemaking regarding the HHS mandate. Unfortunately, there were some news reports today that claimed the bishops rejected the White House proposal, ignoring the fact that we bishops said, we welcome and will take seriously the Administrations invitation to submit our concerns through formal comments, and we will do so in the hope that an acceptable solution can be found that respects the consciences of all.I'm glad he clarified that the bishops haven't rejected the proposal. I saw that "rejected" headline in a lot of places yesterday.

Thomas Farrell, it would be the simplest but it would be very expensive ofr the Catholic institutions. To remain competitive with non-Catholic institutions they would have to increase salaries enough to cover what their employees would actually have to pay for the insurance plus the additional taxes the employees would have to pay on their increased salaries. The employer would also have to pay a tax penalty of $2,000 per employee for not providing insurance.And the end result would be that the employees would have insurance covering contraception.

Jim Pauwels:If that's Dolan's question, he's stupider than I said to the other Jim (and yeah, Jim McRea, I made a typo in my salutation to you), because the way to "refuse" a benefit from an an insurance policy is to NOT CLAIM THAT BENEFIT.Like a whole bunch of this supposedly "complicated" issue, and as I said in a different context above, this is not hard.The only reason this is "complicated" is if the Church hierarchy's hidden agenda is to impose Catholic sexual doctrine on the United States Government's mandated standard benefits package for health insurance.

Raber and I are speculating about how his Amish relatives will handle Obamacare.The Amish pay their taxes ("render unto Caesar") as required by law, but do not register for the draft, serve in the military, apply for Social Security or Medicare, or purchase health care insurance. You get sick, they take up a collection in the community to defray your expenses. His guess is that the Amish will simply pay the opt-out penalty.In the Amish view, we "English" take their money, and they give it up to stay out of jail. But what sins we commit with the money we take from them by force (as far as they're concerned) is no affair of theirs; bishops in many ordnungs, Raber believes, will just counsel the Amish to simply not buy into the latest benefit.Can anyone imagine the Catholic bishops telling the faithful, "Pay your taxes, stay out of jail, but don't accept health care from your employer if it includes contraception coverage. We'll pay for you if you get sick."